Can Bow Legs Be Corrected?

What we often hear

• "My legs look curved. Can that be fixed?"
• "Some places say it can be corrected and others say it can't. I'm confused."
• "My legs look bowed in photos."

Can bow legs be corrected?

Bow legs come in two kinds: those that can be corrected and those that can't. Legs that look curved because of the pelvis and muscles can be corrected, but legs where the bone itself is curved cannot. The first step is telling which one you have.

This is the question we hear most often in the clinic. But the moment we answer "yes," the person starts treatment without knowing which kind of legs they have. Starting without checking means spending time and money on bone that can't be changed back.

How are correctable and non-correctable bow legs different?

We tell them apart by which way the knees face. If both kneecaps turn inward toward each other, muscles are the likely cause. If the knees face straight ahead but there is still a gap between the legs, we suspect the bone.

In bow legs caused by muscles, the thighbone is rolled inward. So the knees face each other instead of facing forward. The gap between the legs comes from this twist, not from a curved bone. The bone itself is fine.

In bow legs caused by curved bone, the shinbone really does curve outward. Even when the thighbone is in the right position, the gap between the legs stays. In this case the knees face straight ahead.

In medical terms, the first is called functional genu varum and the second structural genu varum.

How do you tell them apart in the clinic?

We ask you to stand with your feet together and, keeping your feet in place, turn only your thighbones outward. If the gap between your legs gets visibly narrower, we consider it bow legs caused by muscles.

There is one more check based on the same idea: we ask you to squeeze your buttock muscles. When the buttocks tighten, the thighbones rotate outward. If we see knees that were facing each other come back to face forward, the shape of those legs comes from muscle, not bone.

Both checks show results right away. What matters is that you can see it yourself in the mirror. We find that seeing it with your own eyes, rather than just hearing an explanation, helps people keep up with their exercises afterward.

Type of bow legs	Which way the knees face	When the thighbones are turned	When the buttocks are squeezed	Our call
Caused by muscles	Inward, toward each other	Gap between legs narrows	Knees come back to face forward	Can be corrected
Caused by curved bone	Straight ahead	No change	No change	Check with X-ray
A mix of both	Inward, toward each other	Gap narrows only partly	Knees come back only partly	Correct only the muscle part

Do I have to get an X-ray?

If your knees face straight ahead but there is still a gap between your legs, we check with an X-ray. If the gap clearly narrows when you turn your thighbones, we sometimes go ahead without one.

The X-ray has one purpose: to see whether the shinbone is actually curved. If it is, we tell you this is not something correction can fix. Not suggesting "let's give it a try anyway" at this point is a line we hold to.

What if my two legs are different lengths?

If your legs are different lengths, fixing your posture alone won't last; it goes back. We first make up for the length difference, then work on posture. If the order is reversed, your posture falls back to where it was with every step.

Once the growth plates have closed, it is hard to change the length of the bone itself. Among the people we've seen in the clinic, one had shinbones that differed by about 1 cm between left and right. In that case, we started by adding a lift to the shoe on the shorter side so that weight was shared evenly between both legs.

If you leave the length difference alone and just keep correcting posture, the body tilts again to make up for that difference. The same pattern repeats: the pelvis twists and the opposite shoulder rises.

How long does bow leg correction take?

When the bow legs are found to be caused by muscles, we plan for about 20 sessions over roughly 3 months, based on two visits a week. This varies with your starting condition and how much you exercise at home.

We set a time frame in advance so there is a point to check in halfway. At the start and at the midpoint, you stand in the same position and we measure the gap between your knees. We use this record for our decisions in the clinic, and we don't give you the exact numbers. Instead, we tell you something like "last time it was like this, and this time it's like this." When numbers come first, people's moods tend to rise and fall with every good day and bad day.

What are the limits of this judgment?

This article is not a research paper; it is a summary of what we've seen in the clinic. Because there was no comparison group, we can't say for certain what caused what.

Here is where the limits are. First, the rotation check depends on the eye of the person watching. Without a tool to measure angles or imaging, it doesn't leave a number behind. Second, we haven't yet counted how many legs, out of all we see, are a mix of muscle and bone causes. Third, we have no data on how long the correction lasts. How things look after six months or a year is a separate question that needs to be checked.

Fourth, growing children and fully grown adults need to be looked at differently. Children's legs go through stages where their shape changes on its own as they grow. Applying adult standards to children leads to overjudging.

So how do you decide in the clinic?

We don't treat sorting out the type as a step before treatment; it is part of treatment. On the first day we find out which kind you have, you see the result with your own eyes, and then we make a plan together.

When the bow legs turn out to be caused by muscles, we do two things together. With Chuna (Korean manual therapy), we work by hand on the twisted pelvis and shortened muscles, and with exercise therapy we build up the buttock muscles and the deep core muscles. If we do only one of the two, the posture set in the clinic doesn't hold in daily life.

Sometimes we look beyond the legs. If digestion is poor, muscle doesn't build up even with exercise. In that case we work on digestive function too. That's why we ask about digestion even when you've come in about your legs.

The cases described above are based on real clinical experience, but all identifying information has been removed and they have been adapted to reflect patterns common to several cases.

How we work

1. We check which way your knees face — Standing and walking, we check whether your knees face inward toward each other or straight ahead.
2. We have you turn your thighbones — With your feet together and kept in place, you turn only your thighbones outward.
3. We have you squeeze your buttocks — We see whether your knees come back to face forward.
4. This is where the path splits — If the gap between your legs narrows, we consider it bow legs caused by muscles and begin correction. If it doesn't, we check with an X-ray whether the shinbone is curved, and if it is, we tell you this is not something correction can fix.
5. We check the length of both legs — If there is a difference, we add a lift on the shorter side before working on posture.
6. We combine Chuna and exercise therapy — We plan on two visits a week, about 20 sessions over 3 months, and decide together on exercises for you to do at home.
7. We compare with the start — At the start and the midpoint, we measure the gap between your knees in the same position. We use this record for our decisions in the clinic. Instead of numbers, we tell you "last time it was like this, and this time it's like this."

Even with the same treatment, results differ from person to person depending on the starting condition and how much the bone is curved.

Graduated from the College of Korean Medicine, Daegu Haany University. Completed the Workshop of, and member of, the Korean Society of Chuna Manual Medicine for Spine and Nerves; member of the Cyriax Orthopedic Medicine Study Group; completed the specialist course of the FCST Society of TMJ Balance Medicine; completed the expert course of the Society of Korean Medicine for Obesity Research.

Former director of Korean medicine at Pohang Kyunghee Care Hospital · Former director of Korean medicine at Gimhae Dangdang Korean Medicine Hospital · Former director of Korean medicine and head of the Children's Growth Task Force at Yeonsan Dangdang Korean Medicine Hospital.

Practices by recording findings from abdominal, tongue, and pulse diagnosis and comparing them at the next visit.

Graduated from the College of Korean Medicine, Daejeon University. Full member of the Korean Medicine Society, the Society of Korean Medicine for Obesity Research, the Association of Pediatrics of Korean Medicine, and the Korean Society of Korean Medicine Imaging. In charge of problems that start with body shape and posture.

Clinical record (cumulative since opening)	Count
Patients treated	About 20,000
Chuna treatments	About 13,000
Herbal medicine prescriptions	About 2,500

The figures above are cumulative since opening, not annual. We haven't yet tallied return-visit rates or average length of care, so they are not listed.

We measure first, then tell you what can and can't be done. The part that can change is the part we can help with.

If you never got a clear answer about whether it can be done, come in and get measured. After measuring, we'll tell you that same day how much can be changed.